In this wonderful short story, author Jeanette Brown describes a woman’s first visit to an alternative medicine healer. The woman has a persistent cough. Unhappy with the "five seconds per visit your doctor lavishes on you after your two-hour wait in his sterile lobby," she has taken her yoga instructor’s advice and made an appointment with a tall, olive-skinned man whose voice is "low and soothing" and whose manner is slow, relaxed, and personal.The woman, whom the healer diagnoses as "the roadrunner, a busy fidgety type," alternates between interest, skepticism and dismay. She cracks jokes; he doesn’t laugh. He recommends diet, exercise, no caffeine, and colon cleansing. She mentally rolls her eyes until, his hands massaging her foot, she feels her stomach lurch, a twinge in her armpit and begins to think of her body as "a human pinball machine." Whenever her self-defensive, rational, traditional beliefs almost propel her off the exam table and into her clothes, the healer "nails" her, reading her personality and her lifestyle exactly.Well into the visit, she realizes she hasn’t coughed once. Then, when she’s the most relaxed, incense wafting, his hands kneading all tensions from her back, her mind registering "this is bliss," her esophagus becomes blocked. Sitting up, she coughs, and the healer confronts her. "You have something to say," he insists, and she counters with "You expect me to believe all this mumbo-jumbo?" He tells her she swallows her feelings, and when she coughs again a "feather? A butterfly?" escapes from her mouth and disappears.When the healer pats her back and asks her to cough once more, she can’t. Taking her hands, he declares her "cured." At the story’s end, still not quite able to admit that this strange physician has helped her, yet knowing that he has, the woman struggles to count out his fifty dollar fee, finally dropping a handful of bills onto his bench, "hoping he won’t be offended by a tip."

Subtitled "A Memoir of Mental Interiors," this book is both an exploration of self and a search for reasons that led to the suicide of the author's friend, Henry, when both were of college age. But there is more. As the memoir unfolds, we learn that since childhood, the author experienced episodes of inexplicable, preoccupying, repetitive thoughts and behavior patterns--much later diagnosed as obsessive compulsive disorder (OCD). And finally, Barber discusses being drawn to work with mentally retarded people in a group home, and the mentally ill homeless at Bellevue Hospital in New York City.Growing up in an intellectual New England family with a tradition of sending its sons to Andover (a prestigious prep school) and Harvard, Barber was expected to continue the tradition, and so he did. At Harvard, however, Barber found himself disintegrating into obsessive thinking, unable to concentrate, near suicidal. He withdrew from Harvard, went back to his small town, hung out with his friends Henry and Nick, washed dishes in a local restaurant, took courses at the local college. Obsessive thinking continued to torment him.In desperation, he dropped out of college again, quickly finding a position as a "childcare worker" in a local group home. The author believes this step was the turning point that led eventually to effective treatment of his OCD (psychotherapy and Prozac), completion of his education, a fulfilling "career" in mental health recovery, and a happy family life. He is currently an associate of the Yale Program for Recovery and Community Health at Yale University School of Medicine.

This anthology of poems, short stories, and essays derives from the literary magazine, Bellevue Literary Review, which began publication in 2001. The editor of the magazine and her staff have selected what they consider to be the best literary pieces from the Review's first 6-7 years of publication. Like its parent magazine, the anthology focuses on work that addresses the illness experience, health, healing, and the experiences of health care professionals and other caregivers. The anthology is divided into three parts, each of which has several subsections. Part I, "Initiation," looks at patients' introduction to illness and introduction of doctors to medical education and medical practice. Part II, "Conflict: Grappling with Illness," divides into sections on disability, coping, madness, connections, and family. Part III: "Denouement," addresses mortality, death, loss, and aftermath.

The
future of healthcare in the US has long been a subject of debate, with how to
pay for it overshadowing other aspects of the topic. In publishing
this work, the author, Dr. Ezekiel Emanuel, makes clear: “This book is about
[the] transformation in the delivery of care in the United States” needed to
ensure that “all Americans receive consistently higher-quality and lower-cost
care.” (p. 15)
Paying for health care is not
ignored, and indeed how health care payment methods figure in
health care delivery is taken into account.

Emanuel
builds the book around 12 particular transformational practices as developed
and applied in the several different health care organizations he studied. They
included “small physician offices and large multispecialty group practices,
accountable care organizations, large managed-care organizations, and even
for-profit companies.” He admits to finding these organizations in “a careful,
if somewhat haphazard, way” through a combination of serendipitous visits to
some of these organizations, attendance at presentations showcasing some of
them, and personal recommendations received. (p. 15) Emanuel identifies these
12 transformational practices through “carefully observing and ascribing
significance when various groups and organizations in many different geographic
locations, are independently reporting similar things.” (p. 16)

The
12 transformational practices are covered across three chapters in the middle
of the book. The first describes the practices that involve the way physician
offices are structured and operate (e.g., scheduling patients, measuring
physician performance, standardizing care, coordinating care), the second describes
the practices that affect provider interactions with patients (e.g., shared
decision making, site of service considerations), and the third, the practices
that expand the scope of care beyond traditional boundaries (e.g., behavioral
health, palliative care). Emanuel provides considerable detail on what these
transformational practices entail and on the results they produce. These
chapters are preceded by a separate chapter on recent changes in health care
stimulating transformations, and a chapter on essential elements required for
transformation: catalyzing crisis; leadership; culture, governance, and
physician engagement; data; physician management alignment; and financial risk.

Emanuel recognizes that: “No organization can
institute all 12 transformational practices all at once. No organization has
the management capacity to do that.” (p. 197) Thus, he devotes a chapter on how
organizations can adopt the transformational practices that are best suited to
them. He aggregates the practices into three tiers and ranks them by
prioritization. He carves out a separate chapter on “virtual medicine”—a
collection of technologies and methods that enable a range of patient care activities
(e.g., diagnosing, treating, monitoring) between different locations. Emanuel
covers virtual medicine separately because his view is counter to the
conventional wisdom espoused by “the medical techno-utopians,” as he calls them
(p. 166) He allows that it can augment health care organization performance but
itself is not a transformational practice because “healthcare is fundamentally
social.” (p. 175) So as not to leave patients wondering how they could benefit
from these practices, he devotes another chapter for them on how to find a
doctor.

On a stormy night in 1968 a retired, widowed schoolteacher in rural Pennsylvania opens her door to find a young couple, she white, he African American, wrapped in blankets, drenched, and silent. Letting them in changes her life. They have escaped together from a nearby mental institution most locals simply call "The School." The young woman has recently given birth. When Martha lets them in, her life changes forever. Supervisors from "the School" show up at the door, the young man escapes, and the young woman, memorably beautiful, is taken back into custody. The only words she is able to speak out of what we learn has been a years-long silence are "Hide her." Thus she leaves her newborn baby to be raised by a stranger. The remaining chapters span more than forty years in the stories of these people, linked by fate and love and the brutalities of an unreformed system that incarcerated, neglected, and not infrequently abused people who were often misdiagnosed. Homan, the young man who loved Lynnie, the beautiful girl from the institution, was deaf, not retarded. Lynnie was simply "slow," but a gifted artist who recorded many of the events of her life in drawings she shared only with the one attendant who valued and loved her. Though her pregnancy resulted from being raped by a staff member, the deaf man longs to protect her and care for the baby. Years separate them; Homan eventually learns signing; Lynnie's sister befriends her and an exposé results in the closure of the institution. Over those years Lynnie and Homan witness much cultural change in treatment of people like them who were once systematically excluded. They find social identities that once would have been entirely unavailable to them. And eventually, after literal and figurative journeys of discovery, they rediscover each other.

In Dr. Elizabeth
Ford’s Sometimes Amazing Things Happen,
Ford recounts her time spent on the Bellevue Hospital Prison Ward. The memoir
is as much about her own personal growth as it is about the daunting, yet
crucial care she provides to one of the country’s most vulnerable populations, prison inmates from Riker’s Island. Dr. Ford goes from being a nervous intern on her
first day working in the ward to a confident—if not emotionally drained—director
of the forensic pathology service all the while trying to balance her family
life as a wife and mother. Dr. Ford’s patient
encounters with the inmates all center around one crucial thing: trust. In many
of her conversations, Dr. Ford works tirelessly to convince her patients, many
of whom had suffered abuse or neglect in their younger life, that she is on
their team. This process is, more often than not, an uphill battle. Nonetheless,
it is an endeavor we see Dr. Ford embark on repeatedly throughout the memoir.
For as she says, “My job is to try to look past
[what they’ve done] and ... to care for them, to be curious about them and to
be non-judgmental. It is a daily struggle, but one that I have found over the
years [to be] incredibly rewarding."

Volck’s
memoir describes his medical practice and learning in a variety of settings
(Cleveland, Baltimore, Cincinnati), but, more importantly, in non-metropolitan
places, such as Tuba City on the Navajo Reservation in Arizona and rural
clinics in Honduras. He suggests that his knowledge of medicine has largely
come as he has practiced it and not from his formal education. Further, he
believes that best medical practice is not primarily high-tech, urban, or
industrial. Each of the 15 chapters has a title—a topic, a person, or a
theme—but also one or more locations specified. For example, we have “Chapter
One, A Wedding, Navajo Nation, Northern Arizona,” suggesting the importance of
culture and locale. Further, the chapters include personal associations from
several realms beyond the topic and place as Volck seeks to understand medicine,
healthcare, and how we live in the world.

Of the
first seven chapters, five are set in Navajo land, where Volck is an outsider
by his cultural heritage and his profession, a doctor with a pediatrics
specialty. From time to time he reflects on his training, the English verb “to
attend,” and specific patients, such as two-year-old Alice in Tuba City and
eight-year-old Brian in Cleveland. Both children died while in his care. Working
on the front-line of medicine, he considers the weaknesses of our modern
attitudes toward death and our wishes for control. He also wrestles with personal
lifestyle issues of balancing medicine, family, and an urge to write. Other
chapters describe restlessness in his profession, the growth of his family
(including the adoption of a Guatemalan baby girl), hiking in the Grand Canyon,
camping in the rain, and a retreat with Benedictine monks. Chapter 11
“Embodying the Word” discusses literature and medicine, lectio divina (a Benedictine reading practice), and the need to
listen carefully to patients’ stories.The final
chapter returns to Cincinnati, Honduras, and Tuba City. Volck has found more
projects in the Navajo Nation, including a youth service project from his
church. With permission, he conducts interviews and plans a book on the Navajo,
“drawing on cultural history, anthropology, history, medicine, and politics”
(p. 201).

This film focuses on the interaction between 5-year-old Alexandria and Roy, a Hollywood stuntman in the early days of film. The two are residents of a rehabilitation hospital, and both are recovering from falls they’ve taken: he’s paralyzed from the waist down as a result of a failed stunt; she’s broken her humerus as the result of a fall she’s taken in an orange orchard. (A child in a migrant family, she’s been tasked, at 5 years of age—presumably out of economic necessity—with climbing ladders to pick oranges.) Having accidentally intercepted an affectionate note—Alexandria’s child-missive—meant for the kindly but preoccupied nurse Evelyn, paralyzed Roy befriends the girl and quickly wins her over by telling her the wondrous tale of a masked bandit and his companions, all of whom have been betrayed by the evil emperor Odious, and all of whom are united in their quest for vengeance against the ruler. While Roy narrates the story, we see it take place through Alexandria’s eyes, and the characters she envisions are drawn from people in her life. The role of the heroic masked bandit she assigns to Roy himself, blended to a poignant degree with her deceased father. Alexandria sometimes interrupts and asks questions about or challenges the story’s development, whereupon Roy makes adjustments: it’s clear that the story is a co-constructed project. Roy has, however, become increasingly despondent over his paralyzed condition and over the fact that his fiancée has broken off the engagement as a result of Roy’s condition. As time goes on, Roy uses his unfolding story as a means of manipulating Alexandria to retrieve morphine from the hospital dispensary. He tries and fails to commit suicide with the pills that Alexandria supplies. In the process, he winds up bringing about a severe injury to the child. Filled with remorse and guilt, Roy alters his story such that it can be a source of separation between him and the girl: it becomes cruel and violent, and suggests that the hero is a weak, inglorious imposter who deserves to die. The anguished Alexandria protests, demanding that Roy change the story. Roy refuses, insisting that “It’s my story.” But Alexandria retorts, “It’s mine, too.” And Roy relents. The masked bandit of the story is redeemed, and Roy himself is as well. The film closes first with Roy, Alexandria, the hospital patients and staff watching the film in which Roy’s acting had led to his accident. As the scene approaches the point where the accident had occurred, Roy feels understandable anxiety; but the film has of course been edited. Roy is relieved, but turns to Alexandria, in the hopes that she is not terrified. He finds her beaming. Then the film we are watching, The Fall, shifts to a rapid series of black-and-white footage of stunts—the effect is reminiscent of the love scenes gathered at the end of Cinema Paradiso—narrated by the marveling Alexandria. Each clip features a person in imminent, catastrophic danger—who is then impossibly rescued at the last second by fortunate chance. As Alexandria blows us kisses through a character who is falling backward, we are left in a state of bewildered gratitude over this strange gift of stories we human beings offer each other—stories that assure us over and over again how, confronted with the calamities we see no way of escaping, we are nonetheless saved.

Evan Hansen, an awkward, lonely high school senior, struggles
with Social Anxiety Disorder. On the
advice of his therapist, he pens supportive letters to himself:
“Dear Evan Hansen, Today is going to be an amazing day, and
here’s why. Because today all you have
to do is be yourself. But also
confident.”

Connor, another loner student, picks up one of Evan’s
letters and, several days later, commits suicide. When Connor’s parents find the letter, they take
it to be their son’s suicide note. Instead
of dissuading them, Evan concocts an account of a close friendship with the
classmate he barely knew, creating an email trail. Connor’s family swallows the
story.

As Evan gains the attention he has always craved and comes
out of his shell, he finds that he cannot stop himself. He
founds the “Connor Project,” an organization dedicated to preserving his “friend’s”
memory where he shares his musings on social media: “Have you ever felt like nobody was
there? Have you ever felt forgotten in
the middle of nowhere? Have you ever
felt like you could disappear? Like you
could fall, and no one would hear? ...Well, let that lonely feeling wash
away…Lift your head and look around. You
will be found. You will be found.” Once Evan’s postings go viral, the Connor
Project becomes a veritable industry, with a budget, and fans who look to it
for inspiration. As the stakes rise, the
Project can flourish only by being fed more lies.

The speaker of this poem is a nurse who is recalling and
attempting to come to terms with a disturbing clinical encounter she’d had the
week before. (I should note at the
outset that there’s no indication in the poem as to whether the nurse is male
or female. I choose to think of her as
female). What had happened is that a
mother had brought her five-year-old son in for treatment, and the nurse’s exam
revealed that the child had second- and third-degree burns on his torso—in the
shape of a cross. The mother, weeping,
confessed that her boyfriend had, as a punishment, applied a cigarette to the
child’s body—while the mother had held her son.
Seeing the mother’s tears, the nurse considered offering the woman some
Kleenex, but could not bring herself to do so.
The child retrieved the box of Kleenex, then clung to his mother’s
skirt, and glowered at the nurse. Then
the nurse had participated with three others in prying the boy away from his
mother. In the present of the poem, a
week after the encounter, the nurse attempts to deal with the guilt and shame
she feels in her failure of professional decorum and compassion—at having
failed to rise above her moral judgment against the mother and offer the woman
basic human kindness and respect. In
confronting the chaos of her emotions, the nurse turns to a story she’d learned
in high school: the story of St. Lawrence.
The significance of her attempt to think with this story can be
overshadowed, for readers, by the intensity of the clinical encounter she
recalls; but her endeavor is of at least equal significance as the encounter.